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Side effects
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propranolol patient information common serious side effects NHS
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propranolol adverse effects
The medicine shown is Hypernol-20: propranolol hydrochloride 20 mg, a beta-blocker.
Common side effects
- Tiredness, weakness, dizziness or light-headedness
- Cold hands and feet
- Sleep problems, vivid dreams or nightmares
- Nausea, diarrhoea or constipation
- Headache
- Slower heart rate
- Low blood pressure, which may cause faintness when standing
These often improve after the body adjusts. The NHS propranolol guidance lists dizziness, tiredness, cold extremities, sleep difficulty and nightmares among the usual effects.
Seek urgent medical help now for:
- Wheezing, shortness of breath, chest tightness, or an asthma attack
- Fainting, severe dizziness, confusion
- Very slow or irregular heartbeat
- Swelling of lips/tongue, hives, blistering rash, or trouble breathing
- Chest pain
Important cautions
- Propranolol can worsen asthma/COPD because it can cause bronchoconstriction. It is generally avoided in bronchial asthma.
- In diabetes, it can mask warning signs of low blood sugar, particularly a fast heartbeat.
- Avoid alcohol initially because it can add to dizziness and low blood pressure.
- Do not stop it suddenly without the prescriber’s advice, particularly if taken regularly for a heart condition or blood pressure.
If you are having a side effect now, tell me what symptom you have, when you took the tablet, and whether you have asthma, diabetes, low blood pressure, or heart disease.
Side effects
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propranolol adverse effects
For Hypernol-20 (propranolol 20 mg):
Common side effects
- Tiredness or weakness
- Dizziness, especially when standing up
- Cold hands or feet
- Headache
- Nausea, vomiting, diarrhoea, or constipation
- Sleep disturbance, vivid dreams, or nightmares
- Slow heart rate or low blood pressure
- Reduced sexual performance in some people
Serious side effects - seek urgent care
- Wheezing, chest tightness, or difficulty breathing, especially if you have asthma
- Fainting, severe dizziness, very slow pulse, or irregular heartbeat
- New/worsening shortness of breath or swelling of legs
- Severe low blood sugar symptoms, especially in people with diabetes. Propranolol may hide the usual warning sign of a fast heartbeat.
- Face/lip/tongue swelling, widespread itchy rash, or trouble breathing, which may indicate allergy
- Chest pain
Avoid suddenly stopping propranolol unless a clinician tells you to. It can lead to rebound fast heartbeat, raised blood pressure, or chest pain. Propranolol can cause bronchospasm and can slow heart rate or worsen heart block, as described in Morgan and Mikhail’s Clinical Anesthesiology. The NHS side-effect page has additional patient guidance.
Duration of action of these drug
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propranolol pharmacokinetics duration
Hypernol-20 is an uncoated, immediate-release propranolol 20 mg tablet.
- Starts working: usually within 30-60 minutes
- Peak effect: about 1-3 hours after taking it
- Noticeable clinical effect: usually 6-12 hours
- Half-life in the body: roughly 3-6 hours, but its action can last longer than the half-life.
- Mostly cleared from the body: around 1-2 days after the last dose, though this varies with liver function and other medicines.
For physical anxiety symptoms such as fast heartbeat or tremor, people often notice benefit within about an hour. Do not take an extra tablet early because the first one seems slow, unless that is exactly how your prescriber instructed you.
The duration may be longer in liver disease or when interacting medicines slow propranolol metabolism. Barash, Cullen, and Stoelting’s Clinical Anesthesia reports a relatively short half-life of approximately 4 hours. The NHS propranolol information also notes that it begins working within hours.
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